Home milk challenge to confirm cow's milk protein allergy

For children with mild to moderate symptoms

It is important to try your baby with milk now. This is to make sure that any improvement in their symptoms is due to cutting out milk (and they have a cow's milk protein allergy) rather than for any other reason.

Do NOT start this challenge if your child has had a positive blood or skin test (specific IgE or Skin Prick Test) to cow's milk.

Do NOT start this challenge if your child is unwell e.g.

Has a cold or any other lung infections or breathing problems

Any tummy/bowel problems e.g. tummy ache or loose nappies

Any 'teething' signs that are upsetting your child

Atopic dermatitis (eczema) has flared up

Do NOT start this challenge if your child is having any medication which may upset their tummy, e.g. antibiotics

Do NOT try any other new foods during this challenge

Try to write down what your child eats and drinks during the challenge. Also note any symptoms e.g. sickness, loose nappies, rashes or any other changes in their atop dermatitis.

Home challenge for a formula fed baby (those taking formula with or without some breastfeeds):

Follow the advice in the table below: each day, increase the amount of cow's milk formula given in baby's FIRST bottle of the day - (use the scoop provided in each).

Day

Volume boiled water

Cow's milk formulaNo. of scoops

Hypoallergenic formulaNo. of scoops

1

150mls

1 in the 1st bottle of the day

4 in the 1st bottle of the day

2

150mls

2 in the 1st bottle of the day

3 in the 1st bottle of the day

3

150mls

3 in the 1st bottle of the day

2 in the 1st bottle of the day

4

150mls

4 in the 1st bottle of the day

1 in the 1st bottle of the day

5

150mls

5 in the 1st bottle of the day

0 in the 1st bottle of the day

If you have not seen any symptoms in your child by day 5 (when you have completely replaced one bottle a day with cow's milk formula) you can try giving cow's milk formula for each feed they would usually have from a bottle.

Home challenge for an exclusively breastfed baby:

Simply start eating dairy products to the same levels as before starting on the diet.

All babies:

If you see any obvious symptoms e.g. sickness, tummy pains, a rash, itching, STOP the challenge. Go back to the previous formula your baby was taking or to a milk free diet if you are breastfeeding, and inform your GP.

If you do not see any symptoms within 2 weeks of your baby having more than 150mls cow's milk formula per day, or you having resumed your normal diet containing milk, then your baby does not have a cow's milk protein allergy.